Stop Construction of Medical Waste Incinerators in India

"We fear that the disposal of medical waste
through on-site incinerators will be a cure which is
far worse than the disease itself."
-- Ravi Agarwal and Bharati Chaturvedi,
Indian Campaign Against Medical Waste Incineration

The World Bank plans to "cure" India's problem of medical waste disposal with the construction
of hospital waste incinerators throughout a three-state area. But the incinerators will belch out
deadly toxins, dioxins, mercury, arsenic, lead, cadmium and toxic ash. Better, even cheaper,
waste disposal technologies are readily available. Indian advocates for the environment and public
health ask Global Response members to persuade the Bank to stop funding incinerators and to
install safe waste disposal technologies instead.

Medical waste is a serious problem in India, where "ragpickers" sift through contaminated
hospital garbage to recover the glass, paper, plastic and metal that they can sell for recycling. To
protect them and others who might easily find and reuse contaminated needles and other medical
supplies, a safe system of disposing of medical waste is urgently needed.

But the incinerators that the World Bank plan to construct will create MORE toxic pollution.
"The World Bank should not promote the transfer of the worst Western technologies to India and
the rest of the world," says Gary Cohen, a coordinator of Health Care Without Harm (HCWH),
a coalition of over 100 North American organizations working to reform the environmental
practices of the health care industry.

Noting that hospital waste incinerators are among the top sources of dioxins released into the
environment, HCWH says it is "unacceptable for hospitals to be contributing to cancer on the
outside while treating it on the inside."

Instead of incinerating their waste, hospitals should: 1) phase out the use of PVC plastics and
mercury products; safer products are available at competitive prices; 2) reduce, segregate, reuse
and recycle as much waste as possible; 3) shred contaminated waste for volume reduction and to
avoid reuse, and then sterilize the material using high-temperature steam or microwaving before
disposal in landfills.

In India, a coalition of environmentalists and public health advocates, the Indian Campaign
Against Medical Waste Incineration, is demanding that the World Bank implement these safe
technologies instead of building harmful incinerators. They are supported by the World Bank's
own South Asia office, which recommended that hospitals in India segregate and decontaminate
medical waste at source rather than use "imported high-technology incinerators that are expensive
to purchase and difficult to maintain."

Tawhid Nawaz, task manager for the Bank's project, agreed to look into their criticisms of
incineration and the advantages of alternative technologies. In the mean time, the incinerator
project is approved and some funds have already been dispersed -- so immediate corrective action
by the World Bank is needed.

All About Dioxins:

What harm do dioxins do? Dioxins are potent cancer-causing agents. A September 1994 report
by the United States Environmental Protection Agency documents the connection between dioxin
exposure and cancer, birth defects, endometriosis, reduced sperm count and decreased testes size.
Dioxin exposure also damages the immune system, leading to increased susceptibility to infectious
disease. It can disrupt the proper function of hormones -- chemical messengers that the body uses
for growth, development and regulation. Dioxins, furans and phthalates are endocrine-disrupting
chemicals.

What harm do endocrine-disrupting chemicals do? According to a November 1995 statement
released by an international panel of experts, endocrine-disrupting chemicals can undermine
neurological, behavioral and reproductive development and subsequent potential of individuals
exposed in the womb, or (in fish, amphibians, reptiles and birds) the egg. This loss of potential in
humans and wildlife is expressed in both behavioral and physical abnormalities. Widespread loss
of this potential in nature can change the character of human societies or destabilize wildlife
populations.

How do dioxins get into humans? According to the EPA, 90 percent of human exposure to
dioxin is through eating dioxin-contaminated food. How does our food become contaminated?
The incineration of waste that contains chlorine (PVC plastics, for example) produces dioxins.
The dioxins that are released into the air by incinerators settle onto soil, water and plant surfaces.

When dioxin-laden plants or feed are eaten, the dioxins end up in the animal's fatty tissues.
When people eat meat, fish or dairy products, dioxins move up the food chain and into the human
body. Because humans are at the top of the food chain, the dioxin content of human breast milk
is higher than any other food. In their first months of life, human babies get very large doses of
dioxins.

Requested Action:

Write a polite letter to Andrew Steer, Director of the Environment Department at the World
Bank.

Commend the World Bank for addressing the critical need for safe medical waste disposal in
India.

Point out that incineration is unsafe and creates new pollution problems; the World Bank's
own South Asia office has recommended against incineration of medical waste in India.

Ask the World Bank to replace medical waste incinerators with cleaner, safer, less expensive
technologies in the Indian State Health Systems Development Project and all other World
Bank projects, both present and future.

This Global Response Action was issued in support of and with information provided by the
Indian Campaign Against Medical Waste Incineration, Health Care Without Harm, and the
Multinationals Resource Center.

For more information about the dangers of medical waste incineration, and how you can protect
your own community, please contact Charlotte Brody, Coordinator, Health Care Without Harm,
c/o CCHW, PO Box 6806, Falls Church VA 22040. Tel. 703/237-2249. E-mail:
CCHW@essential.org A national campaign to educate the US public about medical waste
incineration is just getting off the ground. Find out how your hospital disposes of its waste!

GLOBAL RESPONSE is an international letter-writing network of environmental activists. In
partnership with indigenous, environmentalist and peace and justice organizations around the
world, GLOBAL RESPONSE develops Actions that describe specific, urgent threats to the
environment; each Action asks members to write personal letters to individuals in the
corporations, governments or international organizations that have the power and responsibility to
take corrective action. GR also issues Young Environmentalists' Actions and Eco-Club Actions
designed to educate and motivate elementary and high school students to practice earth
stewardship.